Dr Emer Lawlor's marathon ordeal in the witness box ended yesterday after her 18th day of evidence. Much of that time was unnecessarily spent on financial matters, which have been held over for a future witness, as Dr Lawlor has claimed not to have expertise in the area.
It was an unfortunate waste of the tribunal's time for a number of reasons, not least because Dr Lawlor's resistance to answering questions on finances gave the impression at times that the Irish Blood Transfusion Service, as the BTSB is now known, was unwilling to examine a possible profit motivation behind its past actions. To many observers, her reticence struck of the overly defensive and unrepentant attitude associated with the board of old.
But to conclude this would be a distortion of Dr Lawlor's evidence. Leaving financial matters aside, one is left with a damning verdict on the state of the BTSB and its actions in the 1980s.
From her analysis of documentation from the period she has concluded that the board's decision-making procedures were "tortuous", lacking both decisiveness and urgency. She has conceded that the board was "unduly complacent" about the risk of HIV and had an unrealistic opinion about the safety of blood products made from Irish plasma. And, in relation to seven haemophilia B patients infected with an untreated Pelican House product, she has admitted that some of them would be alive today if the board had acted more swiftly.
The tribunal is now to hear testimony from a number of senior officials who worked for the board during the period in question. Dr Vincent Barry, former regional director of the BTSB's Cork centre, is to give evidence today, followed by Dr Terry Walsh, former assistant director and consultant haematologist to the BTSB. Dr Walsh's evidence will be particularly significant, as he played a major role in formulating the board's response to the threat of HIV.
But, as the tribunal heard yesterday, this issue was just one of many he was struggling to deal with at the time. Dr Walsh, who was cited for "neglect of his duty" in the Finlay report on anti-D infection, was said to have been put in a extremely difficult situation as a result of staff cutbacks, an expanded workload and ad-hoc management arrangements. For a period, he was the only consultant in Pelican House. Dr Lawlor said that a similar-sized operation in the UK would have had about five consultants. Summing up the system within which Dr Walsh had to operate, she said it was "totally inadequate".
Ironically, the IBTS is currently taking legal action against Dr Walsh over the infection of women with hepatitis C through anti-D immunoglobulin.
A High Court action was lodged almost two years ago in an attempt to recoup some of the compensation costs, which have run into hundreds of millions of pounds. The case will be fought by a UK-based insurance company from which Dr Walsh obtained his professional indemnity cover. It, rather than Dr Walsh, will be liable to pay costs.